The number of heart transplants performed by University of Minnesota Health surgeons spiked in 2016, and program leaders expect volume to climb higher in the future, thanks in part to new technology that keeps donor hearts healthy during transplant.
Last year, University of Minnesota Health care teams performed 29 adult heart transplants and three pediatric transplants, for an annual total of 32. Between 2010 and 2015, the program averaged roughly 24 transplants a year, though in the past the annual totals have been higher.
Cardiovascular and Thoracic Surgeon Ken Liao, MD, PhD, says an innovative device, called the Organ Care System—more commonly known as “beating heart in a box” technology—has sparked the increase.
Developed by Transmedics, this beating heart technology keeps the heart beating and pumping warm blood during transportation from the donor to the recipient. This maintains the health of the organ longer, allowing care teams to transport the heart over greater distances if needed.
The technology also allows physicians to assess the health of a donor heart before transplantation, allowing them to test hearts and potentially use organs that in the past would have been considered unsuitable.
The system is similar to “breathing lung” technology that experts hope will revolutionize lung transplants and make more organs available for patients.
The University of Minnesota Health heart transplant program used “beating heart” technology on four potential donor hearts in 2016. Only two of the hearts were considered healthy enough for transplant when they arrived. But in the past, all four would have been considered unsuitable for transplant, Liao said.
Liao oversees a clinical trial evaluating the beating heart transport technology for wider use. The University of Minnesota Health program is one of only five programs in the United States equipped with the system.
“This system allows us to take a second look at hearts we would have traditionally rejected,” Liao said. “Because the technology keeps hearts healthier during transport from the donor to the recipient, it should allow us to use a significant number of donor hearts we previously considered unusable—and that’s a huge gain for the transplant community.”
Cardiovascular and Thoracic Surgeon Ranjit John, MD, who also performs heart transplants, says improved collaboration between medical specialties and care teams at University of Minnesota Health has also contributed to the growing number of successful transplants.
“Communication and dialogue and a great working relationship between the heart failure cardiologists and the surgeons and other departments—that’s key,” John said. “Did we have that in the past? Yes. Is it a better relationship now as we grow and learn more about this new technology? Yes.”
"I also attribute the success of many of our heart transplant patients to the expertise of our infectious disease and immunology specialists," John said.
Both Liao and John said they expect the annual number of heart transplants to increase moving forward thanks to the beating heart technology, which will help to reduce some of the major barriers to the donor heart pool, like population and distance.
Because of Minnesota’s location in the Midwest, there is a significantly smaller donor heart pool compared to the nation’s coasts, Liao said. Donor organs are only viable for a limited time once outside the body. Because potential donors may be far away from the recipient’s hospital, transplant centers struggle to get a donor heart to the recipient within a short amount of time.
Beating heart technology allows potential donor hearts from outside the region to travel farther and means University of Minnesota Health care teams could bring in hearts from other states if needed.
“Once we get used to this new technology and gain more experience with it, we’ll be employing it more broadly,” Liao said. “In the beginning, we were more careful and had more concerns—but now that we’re familiar with it, it’s going to continue to increase the number of patients we can help.”